The delivery stop has these consequences

Does the delivery stop at Johnson & Johnson threaten further vaccination delays? What side effects were there – and what could be the cause? Answers to important questions.

From Anja Martini, tagesschau.de

How did the delivery stop come about?

In the USA, a vaccination ban with the active ingredient from Johnson & Johnson has been imposed. The CDC and the FDA had recommended this exposure. The reason for this were noticeable side effects: Six people were diagnosed with sinus vein thrombosis – that is, cerebral vein thrombosis – between six and 13 days after the vaccination. In three cases, thrombocytopenia, i.e. a lack of blood platelets, also occurred. They are women between the ages of 18 and 48 years. The delivery of the Covid-19 vaccine to the European Union had only started on Monday. Johnson & Johnson has committed to delivering 55 million cans by the end of June, with a total of 200 million cans to the EU this year. Because of the reports of complications, the US manufacturer postponed its delivery to the EU countries.

How many doses of the vaccine did Germany expect?

According to previous delivery commitments, Germany expects around ten million doses of the Johnson & Johnson preparation for the second quarter. These are now canceled. A first delivery of more than 230,000 doses of the corona vaccine arrived at the Bundeswehr pharmacy in Quakenbrück (district of Osnabrück) on Tuesday. All corona vaccination doses for Germany will first be brought there. From there the vaccine should then be distributed to the federal states.

Are there now further vaccination delays in Germany?

Not clear. The SPD health politician Karl Lauterbach does not expect any lasting damage to the vaccination campaign in Germany. The thrombosis cases were to be expected after the cases with the similar vaccine from AstraZeneca, according to Lauterbach im Deutschlandfunk . He assumes that the complication is so rare that after a while the vaccine will be vaccinated again in the USA and the start of vaccination will then also begin in Europe. In Bavaria, for example, a spokesman for the state health ministry told the Reuters news agency that the provisional delivery stop would not require any changes to vaccination planning in Bavaria. The vaccine had not yet been fed into the vaccination logistics. This is different in Brandenburg: Also because 6,700 vaccine doses from Johnson & Johnson would not initially be delivered to Brandenburg, this exacerbates the already existing bottlenecks, said State Interior Minister Michael Stübgen. Appointments for first vaccinations would be stopped.

How is the EU reacting to the delivery stop?

The European Commission has ordered a total of 50 million additional doses of corona vaccine from BioNTech / Pfizer. They should be delivered by the end of June. BioNTech / Pfizer also agreed to deliver the cans scheduled for the fourth quarter as early as the end of April. The total delivery volume from Biontech / Pfizer for the second quarter increases to 250 million cans. These are distributed across the EU.

How does the Johnson & Johnson vaccine work?

The Johnson & Johnson vaccine is – just like that from AstraZeneca – a so-called vector vaccine. The genetic blueprint of part of the coronavirus is packaged in a weakened carrier virus that is not harmful to humans. This carrier virus brings parts of the genetic material of the virus into the cell. The human cell replicates these parts of the virus. The immune system reacts and makes antibodies. This makes Johnson & Johnson’s mode of action the same as that of the AstraZeneca vaccine. However, only one dose of vaccine is required for the Johnson & Johnson vaccine. All other active ingredients previously approved in Germany must be vaccinated twice.

What causes the thrombosis?

Scientists believe it may be related to the specific type of these vaccines. “The fact that both vaccines are based on the same principle and cause the same problems, in my opinion, suggests that the vector itself is the cause,” said Johannes Oldenburg from the Bonn University Hospital of the German Press Agency. However, this is speculative at the moment. It is theoretically also conceivable that the spike protein of the virus, which is presented to the immune system in all available vaccines for the formation of antibodies, causes the side effects, explained Oldenburg. It is also fundamentally possible that the side effects are triggered unspecifically as part of the general immune response. Clemens Wendtner, chief physician at Munich Clinic Schwabing, also suspects that the side effects of both vaccines are based on a similar mechanism. “In the case of Johnson & Johnson, we have the same side effects that we have with AstraZeneca,” says Wendtner. “The question arises as to whether there is a class effect here, in other words the adenoviruses that are used as vectors that trigger problems.” Scientists at the University Medical Center Greifswald suspect a possible cause of the complications that the thrombosis is a defense reaction of the blood platelets. This led to the formation of blood clots in the brain.

What were the consequences of similar side effects with AstraZeneca?

Rare cases of thrombosis in the past few weeks had sowed doubts about the AstraZeneca vaccine and led to a temporary stop of vaccinations with this agent. By April 8, 46 cases of sinus vein thrombosis after vaccination with the AstraZeneca vaccine (new name: Vaxzevria) had been reported to the Paul Ehrlich Institute, in 24 cases additionally thrombocytopenia. Five women and three men died. With the exception of seven cases, all reports concerned women between the ages of 20 and 66 years. The men were 24 to 58 years old. In Germany, this vaccine can now only be used without restriction in people aged 60 and over .

What are cerebral vein thrombosis?

Sinus vein thrombosis is blood clot in veins in the brain that drain blood from the brain. Symptoms can be headache, but also epileptic seizures, paralysis or speech disorders. According to the Paul Ehrlich Institute, the blood clots in the cerebral veins occurred together with thrombocytopenia, i.e. a lack of blood platelets. Platelets are also responsible for blood clotting. A lack of platelets leads to an increased tendency to bleed. Symptoms include punctiform bleeding into the skin or mucous membranes, and severe nosebleeds are also possible.